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Pharm 2 Test 2 > GI Drugs (Week 4) > Flashcards

GI Drugs (Week 4) Flashcards

1
Q

What does CTZ stand for?

A

Chemotherapy Trigger Zone

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2
Q

What does CINV stand for?

A

Chemotherapy Induced Nausea and Vomiting

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3
Q

What is the regular dose for Ondansetron (Zofran)?

A

4 mg IVP

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4
Q

What is the MOA of ondansetron (Zofran)?

A

Blocks type 3 serotonin receptors on afferent vagal neurons in the upper GI tract

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5
Q

What is ondansetron used for?

A

N/V associated with CINV

Anesthesia induced

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6
Q

What are some adverse effects of Ondansetron?

A

Headache
Diarrhea
Dizziness
PROLONGED QT INTERVAL

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7
Q

What are some nursing interventions for ondansetron (zofran)?

A

Do not administer to individuals with long QT intervals

Caution in patients who have Hypokalemia

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8
Q

What are the two glucocorticoids?

A

Methylprednisone

Dexamethasone

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9
Q

What is the regular dose for methylprednisone (Solumedrol)?

A

2 doses of 125-500 mg IV 6 hours apart

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10
Q

What is the regular dose of dexamethasone (Decadron)?

A

10-20 mg IVP

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11
Q

What are the glucocorticoids methylprednisolone (Solumedrol) and Dexamethasone (Decadron) used for?

A

Suppreses CINV

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12
Q

What are the adverse effects of the glucocorticoids methylprednisolone (Solumedrol) and Dexamethasone (Decadron)?

A

Hypersensitivity
Allergy to cows milk
Active infection (benefit vs. risk)

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13
Q

Name a neurokinin1 Antagonist?

A

Aprepitant (Emend)

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14
Q

What is the MOA of Aprepitant (Emend)?

A

Blockade of neurokinin1-type receptors in the chemoreceptor trigger zone

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15
Q

What are the indications for Aprepitant (Emend)?

A

Prevent delayed CINV
Acute CINV
Post-op N/V

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16
Q

What are the adverse effects of Aprepitant (Emend)?

A 
Well-tolerated
Fatigue
Asthenia
Hiccups
Dizziness
Diarrhea 
Rare Liver injury
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17
Q

What are some nursing considerations for Aprepitant (Emend)?

A

Best effect when administered with another antiemetic

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18
Q

Name a Benzodiazepine

A

Lorazepam (Ativan)

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19
Q

What is the regular dose for Lorazepam?

A

0.5 mg to 1 mg

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20
Q

What is the MOA of Lorazepam?

A

increases inhibitory effect of GABA

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21
Q

What are the therapeutic uses for Lorazepam (Ativan)?

A

suppresses CINV

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22
Q

What are the adverse effects of lorazepam (Ativan)?

A

Sedation

Hypoventilation

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23
Q

What are some nursing considerations for lorazepam (Ativan)?

A

Monitor for drowsiness
Risk for abuse
Dependence
Withdrawal

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24
Q

Name 2 Dopamine Agonists

A

Prochlorperazine (Compazine)

Promethazine (Phenergan)

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25
Q

What is the MOA for prochlorperazine and promethazine?

A

Blocks dopamine 2 receptors in CTZ

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26
Q

What are some indications for prochlorperazine and promethazine?

A

Suppresses emesis associated with surgery

Chemotherapy and toxins

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27
Q

What are some adverse effects of prochlorperazine and promethazine?

A

Extrapyramidal reactions
Anticholinergic effects
Hypotension
Sedation

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28
Q

What are some nursing considerations for prochlorperazine and promethazine?

A

Promethazine - can cause respiratory depression

Tissue injury from extravasation and even death

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29
Q

Name two Butyrophenones

A

Haloperidol (Haldol) and Droperidol (Inapsine)

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30
Q

What is the MOA of Haloperidol and Droperidol?

A

Blocks dopamine 2 receptors in CTZ

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31
Q

What are the indications of Haloperidol and Droperidol?

A

Suppresses emesis associated with surgery, chemotherapy, and with toxins

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32
Q

What are the adverse effects of Haloperidol and Droperidol?

A 
Extrapyramidal reactions
Anticholinergic effects
Hypotension 
Sedation
Prolonged QT Interval
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33
Q

What are the nursing considerations for Haloperidol and Droperidol?

A

ECG prior to administration

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34
Q

Name two Cannabinoids

A

Dronabinol (Marinol)

Nabilone (Cesamet)

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35
Q

What are some indications of Dronabinol (Marinol) and Nabilone (Cesamet)?

A

Suppression of CINV
2nd line drug due to possible abuse
Appetite stimulation

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36
Q

What are the adverse effects of Dronabinol (Marinol) and Nabilone (Cesamet)?

A 
Temporal disintegration 
Dissociation
Depersonalization and dysphoria 
Tachycardia 
Hypotension
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37
Q

What are some nursing considerations for Dronabinol (Marinol) and Nabilone (Cesamet)?

A

Caution in use with patients with psychiatric disorders
Patients with cardiovascular disease
Do not combine with alcohol, sedatives or CNS depressants

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38
Q

Name a muscarinic antagonist

A

Scopolamine

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39
Q

What is the MOA of Scopolamine?

A

Suppresses nerve traffic in neuronal pathway that connects the vestibular apparatus of the inner ear to the vomiting center

40
Q

What are the adverse effects of Scopolamine?

A

Anticholinergic effects

41
Q

What are the nursing considerations for Scopolamine?

A

Risk for falls

Wear gloves when applying transdermal route

42
Q

Name an antihistamine

A

Meclizine (Antivert)

43
Q

What is the regular dose of Meclizine (Antivert)?

A

12.5-25 mg every 6-8 hr

44
Q

What is the MOA of Meclizine?

A

Blocks histaminergic receptors that connect the inner to the vomiting center

45
Q

What are the adverse effects of Meclizine?

A

Anticholinergic effects
Urinary retention
CNS Depression
Use cautiously in patients with hepatic/renal impairments

46
Q

What are the three most common drugs used for infectious diarrhea?

A

Ciprofloxacin (Ciproxin)
Azithromycin (Zithromax)
Loperamide (Imodium)

47
Q

What is the most causative agent of infectious diarrhea?

A

E. Coli

48
Q

What infectious diarrhea agent can be used with pregnant women and children?

A

Azithromycin

49
Q

What are the three drugs used to irritable bowel syndrome?

A

Hyoscyamine (Anaspaz)
Psyllium (Metamucil)
Loperamide (Imodium)

50
Q

What is an indication of alosetron (Lotronex)?

A

Approved only in women with severe IBS-D that has lasted more than 6 months

51
Q

What is the MOA of Alosetron (Lotronex)?

A

Selective blockade of 5-HT3 receptors found primarily on neurons that innervate the viscera

52
Q

What are the adverse effects of alosetron (Lotronex)?

A

Constipation
Ischemic colitis
Potential GI toxicity

53
Q

What are some nursing considerations for alosetron (Lotronex)?

A

Do not administer to men

Notify HCP if constipation or ischemic colitis occurs

54
Q

What are indications for Libiprostone (Amitiza)?

A

Approved for IBS-C in women aged 18 and older

55
Q

What is the MOA of Lubiprostone (Amitiza)?

A

Selective activation of chloride channels in epithelial cells of the intestine, increases fecal exertion

56
Q

What are the adverse effects of Lubiprostone (Amitiza)?

A

Nausea
Diarrhea
Chest discomfort
**Do not use with patients with bowel obstruction

57
Q

What are some nursing considerations with Lubiprostone (Amitiza)?

A

Take with food and water

Efficacy in men not established

58
Q

What is an indication for Linaclotide (Linzess)?

A

Approved for treatment of IBS-C and CIC

59
Q

What are the adverse effects of Linaclotide (Linzess)?

A

Diarrhea
Hypovolemia
Hypotension

60
Q

What are some nursing considerations for Linaclotide (Linzess)?

A

Educate patient to contact HCP is severe diarrhea occurs

61
Q

What labs should you monitor with Linaclotide (Linzess)?

A

Potassium

Sodium

62
Q

Transmural inflammation that usually affects the terminal ileum
*Cobblestone appearance

A

Crohn’s Disease

63
Q

Inflammation of th mucosa and submucosa of the colon and the rectum
*Rectal bleeding can occur

A

Ulcerative Colitis

64
Q

What is the goal of pharmacological treatment for CD and UC?

A

Manage symptoms, no cure

65
Q

What is sulfasalazine (Azulfidine) used for?

A

Approved to treat both UC and Crohn’s and RA

66
Q

What is the MOA of sulfasalazine (Azulfidine)

A

Reduces inflammation oby suppressing prostaglandin synthesis suppression and suppression of the migration of inflammatory cells in the affected area

67
Q

What are the adverse effects of sulfasalazine (Azulfidine)

A 
Nausea
Fever
Rash 
Arthralgia 
Agranulocytosis 
Hemolytic anemia 
SJS?
68
Q

What labs do you monitor with Sulfasalazine (Azulfidine)?

A

WBC’s

H&H

69
Q

What is the MOA of azathioprine (Imuran) and mercaptopurine (Purixan)?

A

halts replication of DNA and blocks the pathway of purine synthesis

70
Q

What are some indications for azathioprine (Imuran) and mercaptopurine (Purixan)?

A

Long term therapy for UC and Crohn’s

71
Q

What are some adverse effects of azathioprine (Imuran) and mercaptopurine (Purixan)?

A

Pancreatitis
Neutropenia
Thrombocytopenia
Progressive multifocal leukoencepalopathy (PML)

72
Q

What are some nursing considerations for azathioprine (Imuran) and mercaptopurine (Purixan)?

A

Reserved for patients who do not respond to traditional therapies due to toxicities
Cannot be used as a monotherapy

73
Q

What are the indications for Cyclosporin (Sandimmune)?

A

Reserved for acute, severe UC or Crohn’s disease not responsive to glucocorticoids

74
Q

What are some adverse effects of Cyclosporine?

A

Renal impairment due to nephrotoxcitiy

75
Q

Name the immunosuppressants

A

Azathioprine (Imuran)
Mercaptopurine (Purixan)
Cyclosporine (Sandimmune)

76
Q

Name an immunomodulator

A

Infliximab (Remicade)

77
Q

What is the MOA of Infliximab (Remicade)?

A

Monoclonal antibody designed to neutralize TNF

78
Q

What are some indications for Infliximab (Remicade)?

A

Moderate to severe Crohn’s
UC
RA
Lupas

79
Q

What are the adverse effects of Infliximab (Remicade)?

A

Infection
Infusion reactions
Cardiopulmonary reactions

80
Q

What are some nursing considerations for Infliximab (Remicade)?

A

Negative TB test required prior to administration

Advise female patients to notify HCP of pregnancy

81
Q

Name a Prokinetic agent

A

Metoclopramide (Reagan)

82
Q

What is the regular dose of metoclopramide (Relgan)?

A

10 mg PO/IV

83
Q

What is the MOA of Reglan?

A

Blocks receptors for dopamine and serotonin in the CTZ to suppress emesis
Enhances the action of acetylcholine to increase upper GI motility

84
Q

What are the indications of metclopramide (Relgan)?

A

Suppression of post op N/V
Suppression of CINV
Facilitation of small bowel intubation and radiologic exam of GI tract

85
Q

What are the adverse effects of Metoclopramide (Relgan)?

A 
Sedation
Diarrhea
Tachycardia 
Long term high dose therapy 
Tardive dyskinesia
86
Q

What are some nursing considerations for Metoclopramide (Reglan)?

A

Therapy should be lowest effective dose

87
Q

What are some contraindications for Metoclopramide (Reglan)?

A

GI Obstruction

Perforation or Hemorrhage

88
Q

Can you drink alcohol with reglan?

A

No

89
Q

What is a major complication of taking Reglan?

A

Neuroleptic Malignant Syndrome (NMS)

90
Q

What are S/S for NMS?

A 
Hyperthermia 
Muscle rigidity 
Altered LOC
Irregular pulse 
Tachycardia 
Diaphoresis
91
Q

What are the three enzymes the pancreas produces?

A

Lipase
Amylase
Protease

92
Q

What can pancreatic deficiency lead to?

A

Difficult digestion

Replacement therapy is needed

93
Q

What are some nursing considerations for Pancrelipase (Creon)?

A

Do not crush, chew, or retain in mouth

94
Q

Name a pancreatic enzyme replacement

A

Pancrelipase (Creon)

95
Q

Name a gallbladder Stone Dissolving Medication

A

Chenodiol

96
Q

What is the MOA of Chenodiol?

A

Secretes bile acid and enhances cholesterol solubility

97
Q

What are the adverse effects of Chenodiol?

A

Dose dependent diarrhea

Liver injury

Pharm 2 Test 2 (4 decks)

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